Apparatus with deployable probe and blade and methods of use

ABSTRACT

The present application discloses apparatuses with deployable probes and blades and exemplary methods of use. In one or more embodiments of the present disclosure, an exemplary handheld apparatus for probing and cutting is provided. Such an exemplary handheld apparatus includes an elongate member having a probe and a blade associated with a first end thereof. The probe comprises a target interaction surface and is selectively movable between a retracted state and a target acquisition state. The blade comprises a cutting edge and is selectively movable between a retracted position and an extended position. The handheld apparatus may additionally include a handle associated with the second end of the elongate member that is operably connected to the probe and the blade. In some embodiments, the disclosed handheld apparatus is sized and shaped for use in endoscopic surgeries.

BACKGROUND 1. Technical Field

This disclosure generally relates to apparatuses for probing and cuttingand associated methods of use. More specifically, the present disclosurerelates to apparatuses comprising a deployable probe for locating atarget to be cut and a deployable blade for cutting said target andassociated methods of using said apparatuses.

2. Related Technology

Tools for cutting include, for example, knives, scissors, and the like.Often, a general cutting tool, such as a pair of scissors, is adaptedfor a particular purpose without departing from its essential design.For example, a child may use a pair of plastic scissors to cutconstruction paper or a chef may use a pair of kitchen shears to cutherbs or break down poultry. In both instances, the basic concept ofpivotally joined blades whose cutting edges are opposed, yetcomplementary, is used as the foundational concept from which each toolis individually fashioned. Although a variety of context-specifictools—whether scissors, knives, or other cutting tools—can be generatedaccording to the foregoing concept, the resultant cutting devices aregenerally linked by the common thread of requiring the user to see whatshe is cutting to accurately, knowingly, and/or specifically cut atarget object.

However, direct access—whether visual or physical—to some target objectsmay be limited. Absent removing physical obstructions to allow fordirect line of sight, there are few options available to enable a userto accurately, knowingly, and/or specifically cut an object obstructedfrom view. Particularly, handheld devices for locating and specificallycutting a target object are lacking.

Accordingly, there are a number of disadvantages with cuttinginstruments that can be addressed.

BRIEF SUMMARY

Implementations of the present disclosure solve one or more of theforegoing or other problems in the art of handheld apparatuses forprobing and cutting specific targets. In particular, one or moreimplementations can include a handheld apparatus for probing and cuttingthat comprises an elongate member with a first end that is associatedwith a probe and a blade. The probe comprises a target interactionsurface and is selectively movable between a probing state and a targetacquisition state. The blade comprises a cutting edge and is selectivelymovable between a retracted position and an extended position.

Apparatuses for probing and cutting as disclosed herein can also includea handle associated with the second end of the elongate member. Thehandle can include a first manually operated control operably connectedto the probe. The first manually operated control can be configured tomove the probe between the probing state and the target acquisitionstate when the first manually operated control is engaged and/ordisengaged. The handle can also include a second manually operatedcontrol operably connected to the blade. The second manually operatedcontrol can be configured to move the blade between the extendedposition and the retracted position when the second manually operatedcontrol is engaged and/or disengaged.

Apparatuses for probing and cutting as disclosed herein may haveparticular applications, for example, as medical devices for performingminimally invasive (e.g., endoscopic) carpal tunnel surgery. In somesuch embodiments, a medical device includes an elongate membercomprising a first end and a second end, with a probe pivotallyconnected to the first end of the elongate member. The probe may beselectively movable between a probing state and a target acquisitionstate. The probe may include a transverse carpal ligament (TCL)interaction surface that is obscured when the probe is in the probingstate and exposed to a TCL when the probe is in the target acquisitionstate. The medical device may further include a blade selectivelymovable between a retracted position and an extended position. The blademay include a cutting edge that is at least partially associated withthe elongate member when the blade is in the retracted position and thatis at least partially associated with the probe in the extendedposition. The cutting edge may be exposed to the TCL when the blade isin the extended position. In one embodiment, the cutting edge may beexposed to the TCL when the blade is in the extended position and theprobe is in the target acquisition state. The medical device may furtherinclude a handle associated with the second end of the elongate member,the handle comprising a first manually operated control operablyconnected to the probe and a second manually operated control operablyconnected to the blade. The medical device may additionally be sized andshaped for use in a minimally invasive (e.g., endoscopic) carpal tunnelsurgery.

Accordingly, apparatuses for probing and cutting are disclosed. Thissummary is provided to introduce a selection of concepts in a simplifiedform that are further described below in the detailed description. Thissummary is not intended to identify key features or essential featuresof the claimed subject matter, nor is it intended to be used as anindication of the scope of the claimed subject matter.

Additional features and advantages of the disclosure will be set forthin the description which follows, and in part will be obvious from thedescription, or may be learned by the practice of the disclosure. Thefeatures and advantages of the disclosure may be realized and obtainedby means of the instruments and combinations particularly pointed out inthe appended claims. These and other features of the present disclosurewill become more fully apparent from the following description andappended claims, or may be learned by the practice of the disclosure asset forth hereinafter.

BRIEF DESCRIPTION OF THE DRAWINGS

In order to describe the manner in which the above recited and otheradvantages and features of the disclosure can be obtained, a moreparticular description of the disclosure briefly described above will berendered by reference to specific embodiments thereof, which areillustrated in the appended drawings. It is appreciated that thesedrawings depict only typical embodiments of the disclosure and are nottherefore to be considered to be limiting of its scope.

The disclosure will be described and explained with additionalspecificity and detail through the use of the accompanying drawings inwhich:

FIG. 1 illustrates a perspective view of an apparatus for probing andcutting according to one or more embodiments of the present disclosure.

FIG. 2A illustrates an apparatus for probing and cutting in anundeployed state according to one or more embodiments of the presentdisclosure.

FIG. 2B illustrates an apparatus for probing and cutting in a partiallydeployed state according to one or more embodiments of the presentdisclosure.

FIG. 2C illustrates an apparatus for probing and cutting in a partiallydeployed state according to one or more embodiments of the presentdisclosure.

FIG. 2D illustrates an apparatus for probing and cutting in a fullydeployed state according to one or more embodiments of the presentdisclosure.

FIG. 3A illustrates a side view of an apparatus having a blade in anextended position according to one or more embodiments of the presentdisclosure.

FIG. 3B illustrates a front view of an apparatus having a blade in anextended position according to one or more embodiments of the presentdisclosure.

FIG. 3C illustrates a side view of an apparatus having a blade in aretracted position according to one or more embodiments of the presentdisclosure.

FIG. 3D illustrates a front view of an apparatus having a blade in aretracted position according to one or more embodiments of the presentdisclosure.

FIG. 4A illustrates a side view of an apparatus having a rotating probeand blade according to one or more embodiments of the presentdisclosure.

FIG. 4B illustrates a front view of an apparatus having a rotating probeand blade according to one or more embodiments of the presentdisclosure.

FIG. 4C illustrates a side view of an apparatus having a blade recessedbetween tines of a probe, the blade being movable to an extendedposition according to one or more embodiments of the present disclosure.

FIG. 4D illustrates a front view of an apparatus having a blade recessedbetween tines of a probe according to one or more embodiments of thepresent disclosure.

FIG. 5 illustrates an apparatus for probing and cutting comprising ahandle according to one or more embodiments of the present disclosure.

FIG. 6A illustrates a system for introducing an apparatus for probingand cutting to a surgical site, the apparatus being depicted within anintroducer sheath according to one or more embodiments of the presentdisclosure.

FIG. 6B illustrates a system for introducing an apparatus for probingand cutting to a surgical site, the apparatus being depicted asextending from an introducer sheath according to one or more embodimentsof the present disclosure.

FIG. 7A illustrates an apparatus of the present disclosure probing atarget site according to one or more embodiments of the presentdisclosure.

FIG. 7B illustrates an apparatus of the present disclosure acquiring atarget acquisition state according to one or more embodiments of thepresent disclosure.

FIG. 7C illustrates an apparatus of the present disclosure acquiring atarget according to one or more embodiments of the present disclosure.

FIG. 7D illustrates an apparatus of the present disclosure acquiring atarget site with a blade in an extended position according to one ormore embodiments of the present disclosure.

FIG. 7E illustrates an apparatus of the present disclosure cutting atarget site according to one or more embodiments of the presentdisclosure.

DETAILED DESCRIPTION

Before describing various embodiments of the present disclosure indetail, it is to be understood that this disclosure is not limited tothe parameters of the particularly exemplified systems, methods,apparatus, products, processes, and/or kits, which may, of course, vary.Thus, while certain embodiments of the present disclosure will bedescribed in detail, with reference to specific configurations,parameters, components, elements, etc., the descriptions areillustrative and are not to be construed as limiting the scope of theclaimed invention. In addition, the terminology used herein is for thepurpose of describing the embodiments, and is not necessarily intendedto limit the scope of the claimed invention.

1. Overview of Surgical Cutting Tools and Methods of Use

In general, surgical procedures are performed to treat pathologicaldiseases (e.g., appendectomy, lobectomy of a cancerous lung, etc.), helpimprove bodily function or appearance (e.g., plastic or reconstructivesurgery), or otherwise repair the body (e.g., repair a ruptured organ orserious injury). A plethora of surgical procedures have been created andmodified over the years and employ a wide variety of surgical tools andsurgical methods. Historically, most surgical procedures fell into thecategory of “open surgery,” which involves the surgeon making a longincision in the patient's body through which surgical instruments areintroduced and also through which the surgeon visualizes the surgery.This type of surgery is particularly invasive and generally requireslong healing time and extended hospital stays, but it is also associatedwith an increased risk of infection, likely due to the surgicalsite—which is normally closed off from the environment—being open andexposed to the elements and any associated infectious agents.

Recently, advances in imaging technologies, electronics, and roboticshave provided surgeons with minimally invasive surgical options toreplace or complement open surgery. For example, endoscopes—a type ofmedical device having a light and a camera—are widely used in minimallyinvasive surgical procedures to provide the surgeon with a view of thesurgical site via the endoscopic camera. The endoscope is introduced tothe surgical site through a small incision, and the endoscopic lightilluminates the surgical site while the endoscopic camera transmits areal-time (or near real-time) display of the surgical site to a monitorin the surgical theatre. Sometimes a second small incision is made nearthe surgical site through which surgical instruments are introduced, buta single incision may be used to introduce both the endoscope and thesurgical instruments. The surgeon may then perform the surgery, viewingthe surgical site on the monitor as opposed to through the open surgicalsite as would be done in an open surgery approach.

In many instances, endoscopic surgeries are beneficial over open surgeryprocedures because they allow for small incisions instead of a largerincision. The small incisions may decrease the healing time, and mayreduce the length of hospital stay. There also tends to be a decreasedrisk for infection for endoscopic surgeries.

Endoscopes are not the only medium by which image-guided surgery may beperformed. Additional options include, as non-limiting examples, the useof ultrasound systems, computed tomography scanners, magnetic resonanceimaging scanners, and the like. Each of these have their own particularset of drawbacks. Some of the foregoing imaging devices require thepatient to be administered a contrast dye, which can, in somecircumstances, cause an allergic reaction, and which are typicallyexpensive. Additionally, magnetic resonance imaging scanners andcomputed tomography scanners are expensive and require specially-trainedtechnicians to operate the device. In general, each of theaforementioned image-guided surgical devices add an additional layer ofexpense to the patient, and in some cases, the use of these devices isredundant or altogether unnecessary.

As a particular example comparing and contrasting open surgery andminimally invasive surgical tools and techniques, carpal tunnel releasesurgery involves the incision of the transverse carpal ligament (TCL)and may be performed using either an open surgery approach orendoscopically. In an open surgery approach, the physician—typically asurgeon—makes an incision in the skin, subcutaneous tissue, and palmarfascia of the patient's palm to directly access and cut the TCL. Thisprocedure is relatively invasive and requires cutting multiple tissuesto complete the surgery, and because the incised tissue is located onthe patient's palm, the surgery can result in a drawn out and painfulrecovery.

Alternatively, carpal tunnel release surgery may be performed as aminimally invasive surgery using an endoscope. The endoscope isintroduced at the patient's wrist and moved to the surgical site atwhich time a specialized cutting tool is either introduced at the samesite as the endoscope or at a second point located on the palm. Ineither case, the endoscope is used to visualize the TCL, and the cuttingtool is used to cut the TCL from underneath. This type of surgerytypically results in faster patient recovery when compared to the opensurgical approach.

2. Handheld Apparatuses for Probing and Cutting and Methods of Use

In one or more embodiments of the present disclosure, a handheldapparatus is disclosed that can be adapted for use as a surgical tool,and which can be used in, for example, carpal tunnel release surgery. Insuch embodiments, the surgical tool comprises a probe pivotallyconnected to a first end of an elongate member (see, for example, FIG.1). The probe comprises a TCL interaction surface that is obscured whenthe probe is in the retracted state and, in at least some embodiments,is at least partially obscured when the probe is in a probing state. TheTCL interaction surface is exposed to the TCL (at the very least) whenthe probe is in the target acquisition state. The blade includes acutting edge that is at least partially associated with the elongatemember when the blade is in the retracted position (see, for example,FIG. 2A). The blade is at least partially associated with the probe whenthe blade is in the extended position (see, for example, FIG. 2D). Thecutting edge of the blade is exposed to the TCL when the blade is in theextended position. In some embodiments, the probe may also be in thetarget acquisition state when the cutting edge of the blade is exposedto the TCL. The surgical tool further provides a handle associated withthe second end of the elongate member that includes a first manuallyoperated control operably connected to the probe and a second manuallyoperated control operably connected to the blade.

Such a surgical tool may be used to transect anatomic structures and mayparticularly be used to perform carpal tunnel release surgery with orwithout the assistance of image-guided surgical tools. In one or moreimplementations, a surgical tool as described herein is introduced to asurgical site (e.g., the wrist) and the probe is advanced and activated(i.e., advanced from a retracted state to a probing state). Theactivated probe pivots away from the elongate member, pressing againstthe ribbed or underside surface of the TCL. Upon extending the probepast the TCL, the probe pivots to a target acquisition state, wherebythe probe is withdrawn until the distal margin of the TCL is acquired bythe probe. The blade may then be moved into the extended position suchthat translocation of the surgical tool toward and/or across the TCLresults in the cutting edge of the blade severing the TCL.

Referring now to the figures, FIG. 1 illustrates a perspective view ofan apparatus 100 for probing and cutting according to one or moreembodiments of the present disclosure. An apparatus 100 includes anelongate member 102, a probe 104 associated with the elongate member102, and a blade 106 associated with the elongate member 102. Asillustrated, the blade 106 is at least partially associated with theprobe 104, being partially disposed between two tines 108 a, 108 bcomprising the probe 104.

The apparatus 100 of FIG. 1 is depicted with the probe 104 in a probingstate and the blade 106 in an extended position. FIGS. 2A-2D illustratesvarious positions and states of deployment that can be accomplished byapparatus 100 according to one or more embodiments of the presentdisclosure. For example, FIG. 2A illustrates apparatus 100 in a fullyundeployed state. That is, as depicted in FIG. 2A, apparatus 100includes a probe 104 in a retracted state and a blade 106 that is in aretracted position, a configuration that may for the purposes of thisdescription be generally referred to as an undeployed state.

In a retracted state as depicted in FIG. 2A, the probe 104 is, in one ormore embodiments, bent towards the elongate member 102, placing thetarget interaction surface 110 of probe 104 proximate to the elongatemember 102. In this position, the target interaction surface 110 is atleast partially obscured from a target. In a retracted position, theblade 106 of FIG. 2A is at least partially associated with elongatemember 102. In some embodiments, the cutting edge 112 of blade 106 isburied within the body of elongate member 102 to prevent the cuttingedge 112 from unintentionally and/or prematurely interacting with atarget or other surrounding structures. In some embodiments, blade 106is recessed within the elongate member 102 and cutting edge 112 isoccluded by the probe 104, the cutting edge 112 being positioned withina recess of probe 104, as shown in FIG. 2A. In other embodiments, thecutting edge 112 of blade 106 is resting on a guard formed on thesurface of the elongate member 102 or is otherwise obscured or occludedfrom a target.

Referring now to FIG. 2B, illustrated is apparatus 100 in a partiallydeployed state according to one or more embodiments of the presentdisclosure. As illustrated, the probe 104 is in a probing/targetacquisition state, and the blade 106 is in a retracted position. Each ofthe foregoing embodiments, including those depicted in FIGS. 2A and 2B,act to prevent the cutting edge 112 from unintentionally and/orprematurely interacting with a target or other surrounding structures.This may, additionally, provide a measure of safety when handling theapparatus 100, as the cutting edge 112 is at least partially unavailable(if not entirely so) for interacting with—and thereby cutting—aphysician, manufacturer or other individual handling the apparatus.

Referring now to FIG. 2C, illustrated is apparatus 100 in a partiallydeployed state according to one or more embodiments of the presentdisclosure. That is, as depicted in FIG. 2C, apparatus 100 includes aprobe 104 in a probing/target acquisition state and a blade 106 in apartially extended position, a configuration that may for the purposesof this description be included as at least one state that falls withinthe scope of a partially deployed state. As depicted in FIG. 2C, theblade 106 is in a partially extended position, being recessed withinprobe 104 such that the cutting edge 112 is recessed within the body ofprobe 104 and unable to interact with and transect elements interactingwith probe 104. In one or more embodiments, the blade 106 is movedbetween a retracted position and an extended position (and any positionthere between) by mechanical force applied by a push bar 115 and furtheradvanced to a fully extended position as shown in FIG. 2D by, forexample, push bar 115 or by any other mechanical means known in the art.

In one or more embodiments, the target acquisition state of probe 104places the target interaction surface 110 away from elongate member 102.For example, a probe may have an arcuate shape such that it is contouredwith a convex side and a concave side, and the target interactionsurface of the probe comprises at least a portion of the surface of theconcave side of the probe. In a probing state (such as in FIG. 2A),therefore, the target interaction surface faces the elongate memberand/or is positioned above the elongate member, and in a targetacquisition state, the concave side of the probe—and thereby the targetinteraction surface—is directed away from the elongate member and/orpositioned adjacent to the elongate member as depicted in FIG. 2C.Additionally, or alternatively, the target interaction surface is thesurface of the probe that contacts the target in a target acquisitionstate. Therefore, in one or more embodiments, the target interactionsurface may not be defined only with respect to its respective locationto the elongate member, but rather, it may be defined with respect tothe target in addition to or independent from its relationship to theelongate member.

Additionally, or alternatively, the partially deployed state of anapparatus for probing and cutting may include a probe in a retractedstate and a blade in an extended position. This state may also beconsidered within the scope of a partially deployed state and isexemplary of one or more embodiments where the probe and the blade areindependently movable with respect to each other. Though independentlymovable with respect to each other, the probe and the blade maynonetheless be connected or otherwise associated. For example, the probeand blade may be connected by one or more rods, pins, or similarmechanism known in the art that allows each of the probe and the bladeto independently move with respect to the other but also provides aconnection between the two components. Further, the probe and blade maybe associated with each other in a retracted state and retractedposition, respectively, or in a target acquisition state and an extendedposition, respectively, even though they are independently movable withrespect to each other. Alternatively, the probe and blade may not beconnected or otherwise directly associated when the disclosed apparatusis in a partially deployed state.

In one or more embodiments, the probe is pivotally joined and/orassociated with the elongate member, and transitioning between theretracted state to the target acquisition state involves the proberotating between states. The rotation and/or pivotal association of theprobe with the elongate member may be accomplished by any means known inthe art, including, for example, providing torsional energy through theuse of a spring or other similar object that stores mechanical energywhen twisted, as known in the art, or through the use of one or moreelastic materials that are attached to a pivot point on the probe suchthat when the one or more elastic materials are stretched (e.g., bypulling) a rotation of the probe is induced about an axis.

In one or more embodiments, the probe may not rotate between a retractedstate and a target acquisition state, but rather may move by any meansknown in the art, including, for example, by sliding between the twostates.

In one or more embodiments, the probe and the blade may be directlyand/or indirectly associated such that movement of one results inmovement of the other. In such embodiments, the partially deployed statemay not be defined with respect to the juxtaposition of the two statesand/or positions of the blade and probe as described above. Instead, thepartially deployed state may describe a transition state of the bladefrom a retracted position to an extended position and the probe from aretracted state to a target acquisition state, or it may describe thetransition state between an undeployed state and a fully deployed state.Stated another way, a partially deployed state includes any combinationof probe states and blade positions that are not the undeployed statedescribed in FIG. 2A (i.e., the probe in the retracted state and theblade in the retracted position) and that are not the fully deployedstate described below with respect to FIG. 2D.

For example, in an embodiment where the probe and the blade are directlyassociated and/or or move dependently with respect to each other, apartially deployed state may comprise the blade transitioning betweenthe retracted position and the fully extended position and the probebeing released from a retracted state but not completely transitioned tothe target acquisition state. The blade may be motivated from oneposition to another by push rod 115. In some embodiments, the probe andblade move dependently with respect to each other, and motivation of theblade by push rod 115 may consequently cause the movement of the probebetween states (e.g., between a retracted state, a probing state, and/ora target acquisition state).

As provided above, the probing state may, in some embodiments, representa transition state and/or intermediate state between the retracted stateand the target acquisition state. Accordingly, the partially deployedstate may comprise an apparatus having a blade in a retracted positionand the probe in the probing state. A probe in the probing state may,therefore, vacillate between the retracted state and the targetacquisition state without permanently and/or fully entering either theretracted state or the target acquisition state.

Referring now to FIG. 2D, illustrated is apparatus 100 in a fullydeployed state. A fully deployed state comprises the probe 104 in thetarget acquisition state and the blade 106 in an extended position. Inone or more embodiments of the present disclosure, the apparatus 100 isin position and/or configured to engage a target when the apparatus isin the fully deployed state. As shown in FIG. 2D, when the blade 106 isin the extended position (e.g., the cutting edge 112 of blade 106 is nolonger recessed within the body of probe 104 as in FIG. 2C) and theprobe 104 is in the target acquisition state, the cutting edge 112 ofblade 106 is proud of the probe 104. That is, the cutting edge 112protrudes beyond the edge of probe 104 such that the cutting edge 112may interact with (and transect) a target.

Though depicted as unobstructed in FIG. 2D, the tip of the blade may, insome embodiments, be recessed within the probe so as to not interferewith or unintentionally cut or poke unintentional targets. Additionally,or alternatively, the tip of the blade may be rounded. Nonetheless, thecutting edge of the blade may still access (and transect) a target.

Referring now to FIGS. 3A-3D, depicted are various views of a probe 104having a slidable blade 106 a according to one or more implementationsof the present disclosure. FIGS. 3A and 3B illustrate a side view and afront view, respectively, of a probe 104 having a blade 106 a in anextended position. FIG. 3A, for example, illustrates blade 106 a in anextended position and at least partially associated with probe 104. Asis, perhaps, better illustrated in FIG. 3B, blade 106 a is disposedbetween tines 108 a, 108 b of the probe 104 when in an extendedposition. Blade 106 a is partially received between tines 108 a, 108 b.Also depicted in FIGS. 3A and 3B, push rod 115 is associated with a baseportion of blade 106 a. In some embodiments, the push rod is associatedwith at least a portion of the probe in addition to or separately froman association with the blade. In other embodiments, the push rod isindirectly associated with one or both of the probe and the blade. Itwill be appreciated that a separate push rod may be associated with theprobe to move the probe between the various states discussed herein.

As illustrated by FIGS. 3C and 3D, when blade 106 a is in a retractedposition, it is at least partially associated with elongate member 102.During transition between the retracted position and the extendedposition, blade 106 a may slide, in one or more embodiments, along asingle axis. In other embodiments, the blade may slide about alongitudinal axis in addition to translocating within one or moretransverse coordinate planes. For example, the blade may slide along asingle axis from a retracted position within the elongate member to anextended position between the tines of the probe while also moving alonga horizontal plane and/or a z-plane, which may function, for example, tolock the blade in an extended position. As an additional example, ablade may be recessed within the elongate body and may be pushed and/orslid upwards away from the elongate body and towards the recess,whereupon the curvature of the tines and/or probe pushes the blade alonga horizontal axis until it is in an extended state with the tip of theblade directly associated with the tines and/or probe. In one or moreembodiments, a mechanical element may provide the force required to movethe blade from a retracted position to an extended position; as depictedin FIGS. 3A-3D, the mechanical element may be push rod 115.

As illustrated in FIGS. 3A and 3C, tines 108 a, 108 b are arcuate, andas better seen by FIGS. 3B and 3D, the tines 108 a, 108 b coalesce intoan apical segment and form a concave region there between. Also seen inFIGS. 3B and 3D, the concave region formed by the arcuate tines 108 a,108 b may, in some embodiments, be disposed about a central axis. In oneor more embodiments, the concave region formed by the arcuate tinesprovides a recess 114 for receiving at least a portion of blade 106 a.The recess may, in an embodiment, be defined substantially near thecentral axis and may similarly be configured to receive blade 106 a.Thus, in a broader sense, some embodiments provide a probe 104 in thetarget acquisition state that defines a recess 114 into which blade 106may be received when in an extended position. Similarly, the recess 114may receive blade 106 when the blade 106 is in the retracted positionand the probe 104 is in the retracted state.

Additionally, or alternatively, a probe may comprise a singular body,whether arcuate or not, that defines a recess for receiving and/orassociating with at least a portion of a blade in an extended orretracted position as described above. The probe may, in someembodiments, occlude one or more parts of the blade and/or may direct atarget over its surface to the recess with the blade therein so theblade may transect the target.

FIGS. 4A-4B illustrate various views of a probe 104 associated with ablade 106 b that is configured to rotatingly transition between aretracted position and an extended position. The probes 104 of FIGS.3A-3D and 4A-4D are substantially the same. As can be seen by FIGS. 4Aand 4B, blade 106 b is in an extended position and, in some embodiments,may be substantially identical to blade 106 a in FIG. 3. Referring toFIG. 4A, illustrated is an exemplary embodiment where the probe 104 andblade 106 b move dependently with respect to each other. That is, asprobe 104 and/or blade 106 b is compelled to move from a retracted stateor a retracted position, respectively, the other element is consequentlycompelled in a like manner. Similar to what was discussed in otherembodiments, push rod 115 may be directly or indirectly associated witheither or both of probe 104 and blade 106 b.

Illustrated in FIGS. 4C and 4D, blade 106 b is initially disposedentirely within recess 114 of probe 104 (as shown in phantom of FIG. 4C)such that a cutting edge of blade 106 b is recessed within the probe 104and/or does not protrude beyond one or more planes tangential to thesurface of tines 108 a, 108 b (e.g., the cutting edge cannot engageand/or transect a target moving along the surface of tines 108 a, 108 bwithout the target entering the recess). Upon activation (shown by thearrows A in FIG. 4C), which in some embodiments is provided by push rod115, blade 106 b may become proud of tines 108 a, 108 b such that it ispositioned to engage and transect an acquired target.

FIGS. 3A-3D and 4A-4D illustrate various particular embodiments thatdescribe the positioning of tines—and the probe, generally—and at leasttwo mechanisms of moving the blade between a retracted position to anextended position. These, however, are not meant to limit the scope ofdisclosed embodiments to just those depicted in FIGS. 3A-3D and 4A-4D.Any other appropriate mechanisms known in the art for transitioning ablade between a retracted position to an extended position may beadapted herein.

Likewise, FIGS. 3A-3D and 4A-4D illustrate probe 104 as having only twotines. It should be appreciated that probe 104 may have any number oftines, including a single body, and may be arcuate or planar, may hookat an apex of one or more tines, or may have any number or otherconfiguration of tines. In one or more embodiments, the tines areentirely separate and do not coalesce into a continuous apical segment.For example, a probe may have two or more tines, which bound an area(e.g., a recess) that is configured to receive the blade but which donot otherwise connect at a distal tip. In one or more embodiments, thetips of the tines may touch or are otherwise closely associated but arenot fused or directly coupled. Additionally, a probe having a singletine may include a recess that associates with the blade. Such a recessmay, for example, be a recessed portion of the singular tine, may be asurface of the tine, or may be an area proximate the single tine thatfrom a perspective view provides a recessed view of the blade withrespect to the probe.

Referring now to FIG. 5, illustrated is an apparatus for probing andcutting comprising an elongate member 202 with a first end associatedwith a probe 204 and blade 206 and a second end associated with handle208. In some embodiments, handle 208 comprises a gripping region210—whereby device 200 can be manipulated—a first trigger 214 and asecond trigger 216.

In one or more embodiments, the first trigger 214 and the second trigger216 may be any manually operated control known in the art, including,for example, a dial, switch, slider, button, lever, or combinationsthereof. The manually operated control(s) associated with the handle,being in operable connection with the probe and/or blade (e.g., via apush rod such as push rod 115 of FIGS. 2A-2D, 3A-3D, and 4A-4D),operates to control the state and/or position of the probe and/or blade.In one or more embodiments, engagement of the manually operatedcontrol(s) causes the probe to move from a retracted state to a probingand/or target acquisition state; additionally, or alternatively,engagement of the manually operated control(s) may cause the blade tomove from a retracted position to an extended position or similarly froma recessed position to a protruding and/or cutting position.Additionally, or alternatively, disengagement of the manually operatedcontrol(s) causes the probe to move from a target acquisition state to aretracted state (or any intermediate state there between, including aprobing state), and/or disengagement of the manually operated control(s)causes the blade to move from an extended position to a retractedposition or similarly from a protruding and/or cutting position to arecessed position.

In the embodiments depicted by FIG. 5, the manually operated control isillustrated as two triggers 214, 216 independently and operablyconnected to probe 204 and blade 206. It should be understood thattriggers 214, 216 are exemplary and could comprise any number or type ofmanually operated control described above and/or known in the art.Further, triggers 214, 216 are understood to have analogous operation inany of the manually operated controls described herein.

In one or more embodiments of the present disclosure, first trigger 214is operably connected to probe 204. First trigger 214 may, in someembodiments, be in operable connection with probe 204 such thatengagement (e.g., depression, extension, or the like) of first trigger214 selectively moves the probe from a retracted state to the probingstate, and to the target acquisition state. In one embodiment,depression of the first trigger causes probe 204 to be released from aretracted state to enter the probing state. Continued and/or increaseddepression of first trigger 214 may cause probe 204 to proceed to atarget acquisition state by any means previously described. As anon-limiting example, probe 204 may be at least partially associatedwith elongate member 202 in a retracted state, and in response to aminor depression of first trigger 214, probe 204 may partially rotateaway from elongate member 202 proportionally to the amount of pressureand/or the degree of depression received and/or experienced by firsttrigger 214. Continued and/or increased depression of first trigger 214provides a proportional rotational movement of probe 204 within theprobing state towards the target acquisition state. In one or moreembodiments, the length of the first trigger movement is directlyproportional to the rotational distance between a retracted state and atarget acquisition state of the probe. In one or more embodiments, thelength of the trigger movement is greater or less than the rotationaldistance between a retracted state and a target acquisition state of theprobe.

As an additional example, the triggers may have one or multiplethresholds such that upon exceeding a first threshold, the associatedprobe advances a predefined distance or is advanced between states. Insome embodiments, the trigger may have two thresholds, a first to movethe probe from a retracted state to a probing state and a second to movethe probe from a probing state to a target acquisition state.Additionally, or alternatively, a trigger may have two thresholds, afirst to move the probe from a retracted state to a probing/targetacquisition state and a second to move the blade from a retractedposition to an extended/cutting position. In some embodiments, thethresholds may be one or more mechanical thresholds or may,additionally, or alternatively, be a tactile sensation provided throughone or more members of the apparatus (e.g., through the one or moretriggers, the handle, and/or the gripping region).

In one or more embodiments of the present disclosure, second trigger 216is operably connected to blade 206 in any analogous way described abovewith respect to first trigger 214 and probe 204. For example, depressionof second trigger 216 causes a proportional advancement of blade 206from a retracted position to an extended position.

In one or more embodiments, releasing a depressed first trigger 214and/or second trigger 216 causes the operably connected component toreturn to an original position (e.g., the retracted state for the probeand the retracted position for the blade). The foregoing may beaccomplished in the same proportional manner—but in reverse—as describedabove when depressing the first and/or second triggers 214, 216, or insome embodiments, releasing the first trigger 214 and/or the secondtrigger 216 to any degree—or to a threshold degree such as, for example,halfway—causes the operably connected element to immediately and fullyreturn to the original position.

In one or more embodiments, the triggers are binary, and move one orboth of the probe and blade from a retracted state/retracted position toa target acquisition state/extended position, respectively. In oneembodiment, activation of a binary trigger may release the probe from aretracted state to a probing state, which automatically proceeds to atarget acquisition state when the freedom of movement allows for suchtransition. As a particular example, an activated trigger may move theprobe from the retracted state to the probing state, at which time theprobe bumps up against the TCL, and upon reaching the distal margin ofthe TCL (and extending far enough past to allow the probe to fullyextend to a target acquisition state), the probe automaticallytransitions from the probing state to the target acquisition state.

The handle may further comprise a tapered region 208 that comprises alarger diameter region connected to the elongate member 202. In someembodiments, the tapered region 208 may allow a user additional leverageor stability when handling apparatus 200. Tapered region 208 mayadditionally, or alternatively, provide structural support to elongatemember 202 and associated handle 208.

In one or more embodiments of the present disclosure, apparatuses 100,200 may be sized and shaped for use in minimally invasive surgicalprocedures. Apparatuses, therefore, may be introduced via any methodknown in the art, including without limitation via a percutaneousprocedure or via a portal opened by incision. An introducer sheath orother surgical device may be employed with apparatuses disclosed hereinto assist in and/or complement introduction of the apparatus into thesurgical site.

In one or more embodiments of the present disclosure, handle 208 mayadditionally comprise manually operated control 220 (depicted in FIG. 5as a lever). In one or more embodiments, an introducer sheath isprovided to advance the apparatus from an introduction site to thesurgical site. The sheath may include an inner layer directly associatedwith the apparatus that maintains the probe and/or blade in a retractedstate/position and may also provide a pathway to the introduction siteand/or the surgical site. Manually operated control 220, when activatedcauses the inner layer of the introducer sheath to retract away from theprobe/blade end of the elongate member, thereby releasing the probeand/or blade and/or allowing for the deployment of the probe and/orblade. Additional manually operated controls (such as triggers 214, 216)may then be operable to control the movement of the probe and/or bladebetween states/positions as described above. In one or more embodiments,the introducer sheath may comprise a two-phase introducer sheath. In oneor more embodiments of the present disclosure, one or more of thesheaths disclosed herein may be translucent and/or transparent.

FIG. 6A illustrates probe 304 and blade 306 in a retracted state andretracted position, respectively, and directly associated with andcovered by sheath member 310. FIG. 6B illustrates movement of sheathmember 310 away from probe 304 and blade 306 in the direction shown bythe arrows, revealing at least a portion of elongate member 302. Themovement of sheath member 310 away from probe 304 and blade 306 may bethe result of manually operated control 220 being activated, but in oneor more alternative embodiments, sheath member 310 may be a measuredlength that is shorter than the length required to transit to thesurgical site so that as the probe and blade of the apparatus approachthe surgical site, the probe/blade end of the apparatus continuestowards the surgical site while the sheath member is arrested, therebydivorcing the sheath member and releasing the probe and blade end of theapparatus.

Also depicted in FIGS. 6A and 6B, blade 306 may be crescent shapedand/or arcuate in a similar manner as probe 304. In such embodiments,the blade may be recessed within the probe and may rotate or slidedependently with the probe. Activation of the blade may, in someembodiments, cause the blade to protrude from the protective recess ofthe probe such that the cutting edge is available to engage and transecta target.

The apparatus referred to herein may comprise a handheld apparatus forprobing and cutting. More preferably, the apparatus comprises a medicaldevice for locating and transecting target anatomical structures. Insuch embodiments, an analogous probe to those described herein isselectively movable between a retracted state and a target acquisitionstate and an analogous blade is selectively movable between a retractedposition and an extended position. The probe may comprise a hook definedby one or more arcuate tines, wherein the concavity of the hook isconfigured to receive a target anatomical structure when in a targetacquisition state. Additionally, or alternatively, a medical device maycomprise a handle having first and second manually operated controls—andany other component—as described above.

The medical device and/or apparatuses described herein may also comprisea surgical tool, and in some embodiments, a surgical tool for use whenperforming carpal tunnel release surgery. FIGS. 7A-7E illustrate anexemplary embodiment of the foregoing. In one or more embodiments, asurgical tool for use when performing carpal tunnel release surgery isintroduced into the patient by any of the means described above or asknown in the art. This includes, for example, the surgical tool beingintroduced via a percutaneous procedure that uses an introducer sheath.The surgical tool, though not depicted as such in FIGS. 7A-7E, may beassociated with an inner sheath of a two-stage introducer sheath uponintroduction at the entry point and for at least part of the transit tothe surgical site. In one embodiment, the introduction site is at ornear the wrist with the surgical site being located at the base of thepatient's palm where the TCL is located.

Referring now to FIG. 7A, illustrated is a surgical tool being advancedalong the TCL 420, particularly along an undersurface 422 of TCL 420that is proximate the dorsal side of the wrist and opposite the palmarside of the wrist. In some embodiments, probe 404 is in the probingstate. This may be accomplished through any means disclosed herein, andparticularly by depression of a handheld trigger (e.g., a first trigger)operably connected to probe 404. In one or more embodiments, thephysician performing the carpal tunnel release surgery depresses thefirst trigger while advancing the probe along the undersurface 422 ofTCL 420. Depression of the trigger translates into the curved (e.g.,convex) surface of probe 404 applying pressure to the ligament 420. Inone or more embodiments, the surgical tool may be sensitive enoughand/or be able to transmit sensory information in such a manner that thephysician can feel the probe through the surgical tool bumping and/ortraversing the ridges on the undersurface 422 of TCL 420. In one or moreembodiments, while the surgical tool is advanced along the undersurface422 of TCL 420 blade 406 is in a retracted position.

As illustrated in FIG. 7B, the surgical tool is advanced to the distalmargin 424 of TCL 420 and encounters the sentinel fat pad just beyondTCL 420. As the resistance against probe 404 decreases, the probe can,in some embodiments, rotate outwards and/or open such that an apicalhook formed at the distal end of probe 404, which in some embodimentscomprises two curvilinear and/or arcuate metal tines that coalesce intoan apical segment, extends just beyond TCL 420. As probe 404 extendsbeyond TCL 420, probe 404 may additionally rotate and/or open such thatit moves into the target acquisition state, and the TCL interactionsurface 410 of probe 404 is proximate TCL 420. As illustrated in FIG.7B, blade 406 is still maintained in a retracted position within theelongate member 402.

Referring now to FIG. 7C, blade 406 is extended into a partiallyextended position within the probe 404 but does not interact with ortransect the acquired TCL. This state, where probe 404 is in the targetacquisition state and blade 406 is in the retracted state, is asdescribed above, a partially deployed state of the surgical tool.

As illustrated in FIG. 7D, upon identifying the distal margin 424 withprobe 404, blade 406 is advanced from the retracted position to theextended position. In some embodiments, this is accomplished by thephysician depressing a second trigger operably connected to blade 406.The second trigger may, when depressed, be a continuous trigger asdescribed above wherein depression of the second trigger enacts aproportional extension of the blade. Additionally, or alternatively, thesecond trigger may act as a two stage trigger such that upon exceeding athreshold force applied to the trigger, the second trigger advances froma first stage to a second stage, the advancement of which causes theoperably connected blade to thrust from a retracted position to anextended position.

In one or more embodiments, activating the second trigger deploys blade406 into an extended position, the blade 406 being positioned between(and associated with) two tines of the probe 406. With the blade 406 inan extended position and the probe 404 in a target acquisition state, asdepicted in FIG. 7D, the surgical tool is considered to be in the fullydeployed state. The surgical tool can then be retreated until thecutting edge 412 of blade 406 is proximate and/or interfacing with TCL420 and the TCL interaction surface of probe 404 is proximate and/orinterfacing with TCL 420.

It will be appreciated that the two triggers described above may be anymanually operated control, including a multi-stage single trigger. Forexample, and with respect to the surgical tool depicted in FIGS. 7A-7E,the probe 404 may be moved from a retracted state to a probing state (asshown in FIG. 7A) by depressing a trigger through a first stage. Thesurgeon may feel a tactile sensation or reach a mechanical resistancepoint at the end of the first stage. The probe may then be free to probethe TCL 420 in a probing state and to engage the TCL in a targetacquisition state (as shown in FIG. 7B). Further engagement of thetrigger past the initial tactile response or mechanical resistance pointtransitions the trigger to a second stage, the result of which is atransition of the blade 406 from a retracted position to at least apartially extended position (as shown in FIG. 7C). In some embodiments,depression of the trigger through the second stage also moves the blade406 into a fully extended position (as shown in FIG. 7D). In someembodiments, advancing the trigger to a third stage moves the blade froma partially extended position within the probe (as shown in FIG. 7C) toa fully extended position (as shown in FIG. 7D).

Referring now to FIG. 7E, the surgical tool is depicted in the fullydeployed state and is drawn towards the TCL 420. As the surgical tool isdrawn toward TCL 420, the cutting edge 412 of blade 406 transects TCL420 into at least two segments 420 a, 420 b. In at least one embodiment,the TCL interaction surface of the probe acts to secure the TCL as thesurgical tool transects the TCL using the cutting edge of the blade. Forexample, the probe may be hook like and may grab or otherwise secure theTCL before and during transection.

As depicted in FIGS. 7D and 7E, the cutting edge 412 of blade 406 may bepositioned relative to the body of elongate member 402 to form an obtuseangle in which the cutting edge 412 of blade 406 may be pressed againstand transect TCL 420. The angle formed between the elongate member andthe blade may be any obtuse angle, including, for example, any anglebetween a range of 95° and 165°, any angle between a range of 105° and150°, any angle between a range of 120° and 150°, any angle between arange of 135° and 150°, any angle between a range of 105° and 135°, orany angle between a range of between a range of 105° and 120°. In one ormore embodiments, the cutting edge 412 of blade 406 is substantiallyorthogonal to TCL 420 as cutting edge 412 transects TCL 420. In one ormore embodiments, the surgical tool is drawn across TCL 420 until TCL420 is completely transected, resulting in distinct and separatesegments 420 a, 420 b.

After TCL 420 is transected—whether entirely or partially—at least oneof the probe and the blade, and in some embodiments both of the probeand the blade, are returned to an original position. For example, theprobe is moved from a target acquisition state to a probing and/orretracted state and the blade is moved from an extended position to aretracted position. This may be accomplished by any mechanism known inthe art. For example, returning the probe and/or blade to the originalposition may be accomplished by releasing and/or lifting one or moretriggers operably connected to the probe and/or the blade. The surgicaltool may then be withdrawn from the surgical site via the entry point.

Using the surgical tool as described above in carpal tunnel releasesurgery provides many benefits over the currently available tools andprocedures. For example, the surgical tool can be used in a minimallyinvasive surgical procedure that only requires a single entry point,whether introduced via an incision or via a percutaneous procedure. Thistranslates into less bleeding, a lower chance of infection, less pain,and less scarring, which typically results in faster patient recoverytimes when compared to open surgical techniques or even other minimallyinvasive surgical techniques that require two portals for performing thesurgery. Additionally, use of the disclosed surgical tool in carpaltunnel release surgery does not require surgical robotics that arecostly and could malfunction during surgery and potentially affectsurgical outcome. Further, the disclosed surgical tool does notrequire—though it may often be used with—an accompanying endoscope orother image-guided surgical instruments (e.g., ultrasound systems,computed tomography scanners, magnetic resonance imaging scanners,etc.). Overall, the disclosed surgical device results in a safer andmore simplistic approach to performing carpal tunnel release surgery.

Many of the foregoing advantages are equally relevant to any of thehandheld apparatuses disclosed herein. Additional advantages—whether inthe particular context of carpal tunnel release surgery or generallyrelevant—include the ability to advance a probe at or near a targetlocation without damaging surrounding structures. For example, the blademay be in a retracted position during the probing stage whereby thecutting edge is safely occluded, thereby preventing any accidentalcutting or snagging of unintended targets.

Also, the probe, in some embodiments, is arcuate such that the probingsurface (e.g., the side opposite the target interaction surface) has aconvex contour that allows the probe to more naturally and/or smoothlyadvance through an environment without snagging and/or tearing anysurrounding structures. In a target acquisition state of the probe, theconvex contour may additionally be configured to purposefully engage atarget. Even then, however, some embodiments of the present disclosureprovide that when the probe is in the target acquisition state, theblade is in a retracted position, preventing any unintentional cuttingfrom occurring. Upon activation (e.g., extension or protrusion) of theblade, the acquired target may be cut. In this way, the handheldapparatuses of the present disclosure provide a device that enablestarget specific cutting.

In one or more embodiments of the present disclosure, the probe and/orblade of the handheld apparatus are operably connected to one or moremanually operated controls on an associated handle. These manuallyoperated controls activate the probe and may, in some embodiments,independently control the positioning of the blade (e.g., operating theblade between a retracted or extended state). Certain advantages of thisinclude the ability to extend the probe and/or blade at a specific timeand/or place followed by retraction of the probe and/or blade so thatwhen the apparatus is withdrawn, no other structures are cut, snagged,or otherwise unintentionally damaged. When used in a surgical setting,this translates into a surgical tool that may be introduced at a distantsite and safely advanced to a target site where a target anatomicstructure is acquired and severed by a selectively extended surgicalblade. The surgical blade and/or probe may then be retracted at thetarget site followed by being safely withdrawn without further orunintentional interference.

3. Abbreviated List of Defined Terms

To assist in understanding the scope and content of the foregoingwritten description and appended claims, a select few terms are defineddirectly below.

For the purposes of this description, the term “associate” or itsequivalents (e.g., associated, associates, etc.) refers to a physicalproximity of a first element to a second element, and in some cases, theterm “associate” includes physical contact or interaction between two ormore elements. For example, if a first element is “associated” with asecond element, the first element may be proximate the second element ormay be contacting one or more portions of the second element. Thus,association of elements includes the temporary or permanent proximity ofthe elements as well as the temporary or permanent physical contact orinteraction between the elements.

The term “blade” refers to any sharp instrument known in the art that isconfigured to cut and can be made of any suitable material, particularlythose materials known and used in the art of surgery (e.g., stainlesssteel, tempered steel, high carbon steel, titanium, ceramic, etc.). Ablade, as used herein, includes any appropriately sized and shapedsurgical knife, scalpel, lancet, or other sharp surgical instrumentsuited to the methods described herein. The blades disclosed herein maybe re-useable or disposable and may be interchangeable.

For the purposes of this description, the term “introduce” is intendedto include any of its common denotative meanings, and particularly inthe context of this description, the term “introduce” may refer toinserting an object (e.g., medicine, surgical tool, etc.) into the bodyof a patient.

The term “introducer sheath” generally refers to a tube that can beintroduced into the body and through which medicines, surgical tools,and/or other medically relevant material may be delivered into the body.As used herein, an introducer sheath may be flexible or rigid and may beof any length and gauge as known and used by those having skill in theart, as appropriate. An introducer sheath may additionally comprise alength and gauge sufficient to introduce the disclosed apparatuscomprising a deployable probe and blade inside the body, regardless ofwhether the length and gauge of said introducer sheath is known and usedby those having skill in the art. When referenced, an introducer sheathis understood to include cannulas, catheters, and any similar devicefalling within the scope of this definition. An introducer sheath mayinclude one or more elements as known in the art, including withoutlimitation, a guidewire, a dilator, a sheath, a side tube (with orwithout a stop cock), a valve, a seal, and/or a locking mechanism. Anintroducer sheath may be used in a vascular procedure as known in theart wherein the introducer sheath is disposed within the lumen of ablood vessel. Additionally, or alternatively, an introducer sheath maybe used in a percutaneous procedure where the introducer sheath isdisposed within the body of a patient but outside of the vasculature.Additionally, or alternatively, an introducer sheath may be disposedwithin the body through an open surgical procedure as known in the art(e.g., cutting any of the epidermis, dermis, subcutaneous tissue,muscle, etc. with a scalpel followed by introduction of the introducersheath into the body through the incision made by the scalpel).

For the purposes of this description, the term “minimally invasivesurgery” as used herein refers to surgical techniques that limit thesize of incisions needed and in so doing lessens wound healing time,associated pain, and risk of infection as compared to open surgerytechniques as known in the art. This term is meant to include, forexample, robotic assisted surgeries and any of the many varieties ofendoscopic surgeries known in the art. This term is also meant toinclude colloquial equivalents such as “band-aid surgery” and “keyholesurgery.”

The term “percutaneous procedure” generally refers to medical procedureswhere a puncture of the skin (e.g., via a needle) is used to accessinner organs, tissues, vasculature, and the like, rather than throughopen surgical procedures (e.g., exposing tissues with the use of ascalpel).

The term “patient” generally refers to any animal under the care of aphysician, as that term is defined herein, with particular reference tohumans under the care of a surgeon or other relevant medicalprofessional.

The term “physician” as used herein generally refers to a medicaldoctor, particularly a surgeon. This term may, when contextuallyappropriate, include any medical professional, including any licensedmedical professional, such as a physician's assistant, a nurse, agenetics counselor, a veterinarian, etc.

The terms “position” and “state” as used with reference to a blade andprobe, respectively, are made with respect to various stages. Forexample, a blade may be in a retracted position or an extended position.A probe may be in a retracted state, a probing state, or a targetacquisition state.

Throughout the disclosure, the probe may be referenced in one or moreprobe states. For example, the probe may be referenced in a retractedstate, a probing state, or a target acquisition state. For the purposesof this disclosure, a retracted state includes any initial state of aprobe where the probe is drawn substantially toward the elongate memberor is otherwise undeployed (see, for example, FIG. 2A). In someembodiments, a probe is nestled within a recess formed within theelongate member when in a retracted state.

For the purposes of this disclosure, a target acquisition state includesany fully extended or fully deployed probe state (see, for example, FIG.2D). It should be understood, however, that the target acquisition statemay also comprise any intermediate state between a retracted state and afully deployed or fully extended state where the probe attaches,associates, or otherwise acquires a target.

For the purposes of this disclosure, a probing state includes any statebetween the retracted state and the target acquisition state. In someembodiments, the probing state includes those intermediate statesbetween a retracted state and a target acquisition state where the probemay be used to probe or identify a potential target. A probe in aprobing state may be selectively movable between a retracted state and atarget acquisition state. In some embodiments, a probing state may beinterchangeable with a retracted state. For example, a probe in aretracted state may be used to search for one or more potential targets.In such an embodiment, the probe may not have substantially moved awayfrom the retracted state but may nonetheless be considered to be in aprobing state and/or a retracted state. Similarly, a probe may be in aprobing state when it is released from a retracted state and is rotatedor otherwise moved to identify a target. As the probe rotates or movesaway from the retracted state, the probe may identify a target at agiven probe position, and without additional rotation or movement fromthe given probe position, the probe may transition from a probing stateto a target acquisition state upon identification of a desired target.Thus, as used herein, a target acquisition state describes those probestates where the probe positively acquires or is otherwise associatedwith a target, and a probing state can be any probe position between (oroutside) the retracted state and the target acquisition state.

Accordingly, in some embodiments, the probe may be in a retracted statewhen the probe is substantially parallel to an elongate member. If, asprovided by some embodiments described below, the probe is rotated froma retracted state to a target acquisition state, the retracted state canbe considered a rotational starting point—or 0° of rotation. In someembodiments, the target acquisition state is any of a 15°, 30°, 45°,60°, 75°, 90°, 105°, 120°, 135°, 150°, 165°, or 180° rotation (in eithera clockwise or counterclockwise direction) from the retracted state, andthe probing state includes any intermediate rotation between (andsometimes including) the retracted state and the target acquisitionstate.

For example, in an embodiment where the target acquisition state is 115°clockwise rotation from the retracted state (e.g. 0°), the probing statemay be any angular rotation between 0° and 115°. In some embodiments,the probing state includes all possible points within an available 360°of rotation from the retracted position, and the target acquisitionstate is defined as the point (e.g., the state) where the probe acquiresa target. As adapted from the previous example, the probing state mayinclude all available rotational states of a given probe that can rotate180° from the retracted state, and upon acquiring a target at, forexample, 115° from the retracted state, the probe can be considered tobe in a target acquisition state.

In some embodiments, the target acquisition state can be a given statewithin a range of states. For example, a desired target may be acquiredby the probe within a range of states, which may vary betweenenvironments but which nonetheless fall within a defined (or reasonablydefined) range of states. As a more particular example, the desiredtarget may be the TCL, which may be acquired by a probe in one or morestates between 30° and 180°, or between 45° and 165°, or between 60° and135°. The probe may, in a probing state, probe for the TCL between anyof the foregoing ranges until the TCL is acquired. The state in whichthe TCL was acquired is the target acquisition state.

In one or more embodiments, the target acquisition state may include thefully extended (or fully rotated) state of the probe away from theretracted state, which in some embodiments may include a targetacquisition state that falls within any of the rotational ranges orrotation states described above. In such embodiments, the probing statemay be defined as any intermediate state between the retracted state andthe target acquisition state.

Throughout the disclosure, the blade may be referenced in one or moreblade positions. For example, the blade may be referenced in a retractedposition or an extended position. For the purposes of this disclosure,the blade is selectively movable between a retracted position and anextended position.

A retracted position includes any initial position of a blade where theblade is drawn substantially toward or within the elongate member or isotherwise undeployed. In some embodiments, a blade is nestled within arecess formed within the elongate member when in a retracted position.

An extended blade position includes any position of a blade that is nota retracted position. The extended position of a blade, as used herein,includes any partially or fully extended blade position.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meaning as commonly understood by one of ordinary skill inthe art to which the present disclosure pertains.

Various aspects of the present disclosure, including devices, systems,and methods may be illustrated with reference to one or more embodimentsor implementations, which are exemplary in nature. As used herein, theterm “exemplary” means “serving as an example, instance, orillustration,” and should not necessarily be construed as preferred oradvantageous over other embodiments disclosed herein. In addition,reference to an “implementation” of the present disclosure or inventionincludes a specific reference to one or more embodiments thereof, andvice versa, and is intended to provide illustrative examples withoutlimiting the scope of the invention, which is indicated by the appendedclaims rather than by the following description.

As used throughout this application the words “can” and “may” are usedin a permissive sense (i.e., meaning having the potential to), ratherthan the mandatory sense (i.e., meaning must). Additionally, the terms“including,” “having,” “involving,” “containing,” “characterized by,” aswell as variants thereof (e.g., “includes,” “has,” “involves,”“contains,” etc.), and similar terms as used herein, including withinthe claims, shall be inclusive and/or open-ended, shall have the samemeaning as the word “comprising” and variants thereof (e.g., “comprise”and “comprises”), and do not exclude additional un-recited elements ormethod steps, illustratively.

It will be noted that, as used in this specification and the appendedclaims, the singular forms “a,” “an” and “the” include plural referentsunless the context clearly dictates otherwise. Thus, for example,reference to a singular referent (e.g., “widget”) includes one, two, ormore referents. Similarly, reference to a plurality of referents shouldbe interpreted as comprising a single referent and/or a plurality ofreferents unless the content and/or context clearly dictate otherwise.For example, reference to referents in the plural form (e.g., “widgets”)does not necessarily require a plurality of such referents. Instead, itwill be appreciated that independent of the inferred number ofreferents, one or more referents are contemplated herein unless statedotherwise.

As used herein, directional terms, such as “top,” “bottom,” “left,”“right,” “up,” “down,” “upper,” “lower,” “proximal,” “distal,”“adjacent,” and the like are used herein solely to indicate relativedirections and are not otherwise intended to limit the scope of thedisclosure and/or claimed invention.

To facilitate understanding, like reference numerals (i.e., likenumbering of components and/or elements) have been used, where possible,to designate like elements common to the figures. Specifically, in theexemplary embodiments illustrated in the figures, like structures, orstructures with like functions, will be provided with similar referencedesignations, where possible. Specific language will be used herein todescribe the exemplary embodiments. Nevertheless, it will be understoodthat no limitation of the scope of the disclosure is thereby intended.Rather, it is to be understood that the language used to describe theexemplary embodiments is illustrative only and is not to be construed aslimiting the scope of the disclosure (unless such language is expresslydescribed herein as essential).

While the detailed description is separated into sections, the sectionheaders and contents within each section are not intended to beself-contained descriptions and embodiments. Rather, the contents ofeach section within the detailed description are intended to be read andunderstood as a collective whole where elements of one section maypertain to and/or inform other sections. Accordingly, embodimentsspecifically disclosed within one section may also relate to and/orserve as additional and/or alternative embodiments in another sectionhaving the same and/or similar systems, devices, methods, and/orterminology.

Various aspects of the present disclosure can be illustrated bydescribing components that are bound, coupled, attached, connected,and/or joined together. As used herein, the terms “bound,” “coupled”,“attached”, “connected,” and/or “joined” are used to indicate either adirect association between two components or, where appropriate, anindirect association with one another through intervening orintermediate components. In contrast, when a component is referred to asbeing “directly bound,” “directly coupled”, “directly attached”,“directly connected,” and/or “directly joined” to another component, nointervening elements are present or contemplated. Furthermore, binding,coupling, attaching, connecting, and/or joining can comprise mechanicaland/or chemical association.

Various alterations and/or modifications of the inventive featuresillustrated herein, and additional applications of the principlesillustrated herein, which would occur to one skilled in the relevant artand having possession of this disclosure, can be made to the illustratedembodiments without departing from the spirit and scope of the inventionas defined by the claims, and are to be considered within the scope ofthis disclosure. Thus, while various aspects and embodiments have beendisclosed herein, other aspects and embodiments are contemplated. Whilea number of methods and components similar or equivalent to thosedescribed herein can be used to practice embodiments of the presentdisclosure, only certain components and methods are described herein.

It will also be appreciated that systems, devices, products, kits,methods, and/or processes, according to certain embodiments of thepresent disclosure may include, incorporate, or otherwise compriseproperties, features (e.g., components, members, elements, parts, and/orportions) described in other embodiments disclosed and/or describedherein. Accordingly, the various features of certain embodiments can becompatible with, combined with, included in, and/or incorporated intoother embodiments of the present disclosure. Thus, disclosure of certainfeatures relative to a specific embodiment of the present disclosureshould not be construed as limiting application or inclusion of saidfeatures to the specific embodiment. Rather, it will be appreciated thatother embodiments can also include said features, members, elements,parts, and/or portions without necessarily departing from the scope ofthe present disclosure.

Moreover, unless a feature is described as requiring another feature incombination therewith, any feature herein may be combined with any otherfeature of a same or different embodiment disclosed herein. Furthermore,various well-known aspects of illustrative systems, methods, apparatus,and the like are not described herein in particular detail in order toavoid obscuring aspects of the example embodiments. Such aspects are,however, also contemplated herein.

The present disclosure may be embodied in other specific forms withoutdeparting from its spirit or essential characteristics. The describedembodiments are to be considered in all respects only as illustrativeand not restrictive. The scope of the invention is, therefore, indicatedby the appended claims rather than by the foregoing description. Whilecertain embodiments and details have been included herein and in theattached disclosure for purposes of illustrating embodiments of thepresent disclosure, it will be apparent to those skilled in the art thatvarious changes in the methods, products, devices, and apparatusdisclosed herein may be made without departing from the scope of thedisclosure or of the invention, which is defined in the appended claims.All changes which come within the meaning and range of equivalency ofthe claims are to be embraced within their scope.

What is claimed is:
 1. A handheld apparatus for probing and cutting, comprising: an elongate member comprising a first end and a second end; a probe associated with the first end of the elongate member and being selectively movable between a retracted state and a target acquisition state, the probe comprising a first end, a second end, a target acquisition surface, a recess, and two or more arcuate tines, the first end of the probe being pivotally connected to the first end of the elongate member to enable the probe to pivot between the retracted state and the target acquisition state, the second end being a free end that is uncoupled from the elongate member, the second end of the probe being at least partially disposed within the elongate member when the probe is in the retracted state and outside of the elongate member when the probe is in the target acquisition state, the two or more arcuate tines being disposed about a central axis such that the recess is defined between the two or more arcuate tines, and at least two of the two or more tines coalesce into an apical segment; and a blade associated with the first end of the elongate member and being selectively movable between a retracted position and an extended position, the blade comprising a cutting edge, the blade and the probe being movable independent of one another, and the recess in the probe being configured to receive at least a portion of the blade when the blade is in the extended position.
 2. The handheld apparatus as in claim 1, wherein the target acquisition surface is obscured when the probe is in the retracted state.
 3. The handheld apparatus as in claim 1, wherein the cutting edge of the blade is obscured at least partially by the elongate member when the blade is in the retracted position.
 4. The handheld apparatus as in claim 1, wherein the blade translates when moving from the retracted position to the extended position.
 5. The handheld apparatus as in claim 4, wherein the blade rotates or pivots when moving from the retracted position to the extended position.
 6. The handheld apparatus as in claim 5, wherein the blade is moved from the retracted position to the extended position via a push rod.
 7. The handheld apparatus as in claim 1, wherein the probe is selectively movable to a probing state, the probing state comprising an intermediate state between the retracted state and the target acquisition state.
 8. The handheld apparatus as in claim 7, wherein the handheld apparatus further comprises a handle associated with the second end of the elongate member that is operably connected to the probe by a first manually operated control, the first manually operated control being configured to release the probe from the retracted state to the probing state when engaged.
 9. The handheld apparatus as in claim 8, wherein the second end of the probe is closer to the second end of the elongate member when the probe is in the retracted position, and the second end of the probe is outside of the elongate member and further from the second end of the elongate member when the probe is in the target acquisition state.
 10. The handheld apparatus as in claim 8, wherein the probe is configured to rotate from the retracted state to the target acquisition state when a force exerted on the probe in a direction opposite the direction of rotation is absent or when the first manually operated control is further engaged, forcing the probe towards the target acquisition state.
 11. The handheld apparatus as in claim 8, wherein the first manually operated control is configured to cause the probe to pivot towards the retracted state when the first manually operated control is disengaged.
 12. The handheld apparatus as in claim 11, wherein the blade is associated with the probe such that engagement of the first manually operated control causes the blade to transition from the retracted position towards the extended position and disengagement of the first manually operated control causes the blade to return towards the retracted position.
 13. The handheld apparatus as in claim 8, wherein the first manually operated control is selected from the group consisting of: a dial, a switch, a slider, a button, a lever, a trigger, and combinations thereof; and the handle further comprises a second manually operated control selected from the group consisting of: a dial, a switch, a slider, a button, a lever, a trigger, and combinations thereof, the second manually operated control being operably connected to the blade and configured to initiate movement of the blade from the retracted position to the extended position when the second manually operated control is engaged.
 14. The handheld apparatus as in claim 13, wherein the second manually operated control is configured to initiate movement of the blade toward the retracted position when the second manually operated control is disengaged.
 15. A handheld apparatus for probing and cutting, comprising: an elongate member comprising a first end and a second end; a probe associated with the first end of the elongate member and being selectively movable between a retracted state, a probing state, and a target acquisition state, the probing state comprising an intermediate state between the retracted state and the target acquisition state, the probe comprising a first end, a second end, and a target acquisition surface, the first end of the probe being pivotally connected to the first end of the elongate member to enable the probe to pivot between the retracted state and the target acquisition state, the second end being a free end that is uncoupled from the elongate member, the second end of the probe being at least partially disposed within the elongate member when the probe is in the retracted state and outside of the elongate member when the probe is in the target acquisition state; a blade associated with the first end of the elongate member and being selectively movable between a retracted position and an extended position, the blade comprising a cutting edge, the blade and the probe being movable independent of one another; and a handle associated with the second end of the elongate member, the handle being operably connected to the probe by a first manually operated control, the first manually operated control being configured to release the probe from the retracted state to the probing state when engaged, the first manually operated control being configured to cause the probe to pivot towards the retracted state when the first manually operated control is disengaged.
 16. The handheld apparatus as in claim 15, wherein the probe comprises a hook defined by one or more arcuate tines, a concavity of the hook being substantially towards the elongate member when the probe is in a probing state.
 17. The handheld apparatus as in claim 15, wherein the handle further comprises: a second manually operated control selected from the group consisting of: a dial, a switch, a slider, a button, a lever, a trigger, and combinations thereof, the second manually operated control being operably connected to the blade such that engagement of the second manually operated control selectively moves the blade between the retracted position and the extended position; and wherein the first manually operated control is selected from the group consisting of: a dial, a switch, a slider, a button, a lever, a trigger, and combinations.
 18. The handheld apparatus as in claim 17, wherein the second manually operated control is configured to initiate movement of the blade toward the retracted position when the second manually operated control is disengaged.
 19. The handheld apparatus as in claim 15, wherein the handheld apparatus is sized and shaped for use in a minimally invasive carpal tunnel surgery.
 20. The handheld apparatus as in claim 15, further comprising a two-stage introducer sheath comprising an inner sheath and an outer sheath, the inner sheath being selectively movable relative to the outer sheath, and the handheld apparatus being selectively movable within the inner sheath. 